The influence and correlation analysis of subclinical hypothyroidism on pulmonary embolism
10.3760/cma.j.cn431274-20240102-00005
- VernacularTitle:亚临床甲状腺功能减退对肺栓塞发病的影响及相关性分析
- Author:
Yangyang LI
1
;
Hanyu ZHANG
Author Information
1. 首都医科大学附属北京友谊医院急诊科，北京 100050
- Keywords:
Subclinical hypothyroidism;
Pulmonary embolism;
Coagulation function
- From:
Journal of Chinese Physician
2024;26(11):1687-1690
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the influence of subclinical hypothyroidism (hypothyroidism) on pulmonary embolism and its correlation.Methods:A total of 63 026 patients admitted to Beijing Friendship Hospital of Capital Medical University from August 1, 2013 to August 1, 2023 were retrospectively collected. According to their thyroid function, they were divided into subclinical hypothyroidism group (5 765 patients) and normal thyroid function group (57 260 patients). The incidence of pulmonary embolism was compared between the two groups. The triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) were compared with their prothrombin time (PT), prothrombin activity (PTA), international normalized ratio (INR) and activated partial coagulation in patients with pulmonary embolism with subclinical hypothyroidism The correlation of hemoactivase time (APTT), antithrombin Ⅲ (ATⅢ), fibrinogen (Fbg), fibrin degradation product (FDP) and D dimer (D-D) was observed. Multifactor linear regression method was used to analyze the thyroid function indexes affecting the coagulation function in patients with pulmonary embolism.Results:The incidence of pulmonary embolism was 0.64%(369/57 260) in the normal group and 0.97%(56/5 765) in the subclinical group, the difference was statistically significant (χ 2=8.352, P=0.004). APTT was negatively correlated with T3 and FT3 ( r=-0.301, -0.370, all P<0.05). ATⅢ was positively correlated with T3 and FT3 ( r=0.310, 0.392, P<0.01). PTA was negatively correlated with FT4 ( r=-0.314, P<0.05). FDP was correlated with FT3 and FT4 ( r=-0.521, 0.331, all P<0.05). D-D was correlated with T3, FT3 and FT4 ( r=-0.312, -0.559, 0.387, all P<0.01), while no correlation was found among the other indexes. Multivariate analysis showed that FT3 was an independent influencing factor of APTT and ATⅢ ( β=-4.609, 12.211, all P<0.05), FT4 was an independent influencing factor of PTA, FDP, D-D ( β=-50.524, 35.833, 16.507, all P<0.01). Conclusions:The incidence of pulmonary embolism in patients with subclinical hypothyroidism is higher than that in patients with normal thyroid function. The changes of ATⅢ and FT3 in subclinical hypothyroidism patients with pulmonary embolism were consistent. The change trend of FDP and D-D was consistent with that of FT4, while the change trend of PTA and FT4 was opposite.
